Emergency response is a serious problem. Under such systems as 911, when seconds count, a responder is at least several minutes away. Consider, for example, cardiac arrest. Each Year 330,000 Americans experience sudden cardiac death, yet less than 5% of Americans receive CPR training annually. The majority of these trainees are health care professionals who work in controlled medical environments such as hospitals, ambulances, and clinics. However, the majority of cardiac arrests take place at work or in the home: While EMS systems have evolved to bring trained medical professionals to the scene of a medical emergency more rapidly, the optimal window for medical intervention in a cardiac arrest is often too narrow to allow for the timely transport of equipment and skills to the location of the victim.
The probability of surviving an out-of-hospital cardiac arrest is at least doubled for victims who receive bystander CPR. In addition, cardiac arrest victims who receive bystander CPR and the benefit of an automated external defibrillator (AED) that can deliver a shock to the heart within four minutes quadruple their survival with reports of survival between 34-70%.
However, victims receive the benefit of bystander CPR only 7-28% of the time, and receive the combined benefit of bystander CPR and AED application only 2-3.4% of the time. While researchers and clinicians understand what elements are necessary to improve survival from cardiac arrest, it is as yet not possible to deliver these components to the cardiac arrest victim in a timely fashion.
A major problem in this regard lies in the fact that there is statistically a very small likelihood that a trained responder is present when a cardiac arrest occurs. The bystander, unfamiliar with the emergency medical response, most often does nothing, or merely calls emergency medical services (EMS), i.e., 911.
A sudden cardiac arrest (SCA) is an emotionally daunting event. As such, most laypersons are unwilling to perform unfamiliar tasks, such as AED and CPR, in public under these emotionally charged circumstances. The best EMS response times nationwide are greater than four minutes, and the average response time is between 8-12 minutes. Thus, trained personnel, and the appropriate equipment (AEDs), arrive at the victim's side too late to impact survival. This is best understood when one considers that EMS requires a minimum of an additional 2-4 minutes to process the a call. EMS obtains information regarding responders and equipment voluntarily and is therefore an incomplete network of both trained responders and equipment. EMS has no way to ascertain the continued validity of the information initially provided, which experientially has been demonstrated to change by 20%/year. Further, EMS has no way to ascertain the operational status of the equipment because it does not maintain this information itself. Additionally, EMS has no way to customize the information based on organizational structure, nor does it have the operational plans and protocols of different organizations in the community.
To address this issue, many workplaces have instituted internal emergency response plans and trained workplace personnel in CPR and AED. They have purchased AEDs to be placed at convenient locations throughout the workplace. However, the average number of trained personnel in the workforce averages 2-10% Therefore, victims still do not collapse near their trained responders.
The foregoing discussion considers a single type of medical emergency. Yet, there are many types of medical and non-medical emergencies that require prompt and skilled response. It would be advantageous to provide an approach that enables prompt notification to elicit early response to such emergencies.